The World of Chronic Illness: How Health & Fitness Can Pave a Path Forward for Patients

In this article, we will examine the world of chronic illness (an abridged version). We will touch upon many different types of chronic illnesses and the what-when-where-why and how of the matter. What is chronic illness and what are the different types of chronic illness? Who do they affect? When did it begin? Where does it come from and why? We will then examine chronic illness from the world of health and fitness, and look at how health and fitness can help patients that suffer from said illnesses. Did you know that a disease, an illness and a sickness are the same thing? “A disease refers to the medical establishment’s perspective; sickness refers to society’s perspective, and illness is the way a patient perceives their condition.” (https://english.stackexchange.com) Illness seems to be used more in spoken language and disease seems to be used more in written language.

Disease, Sickness and Illness

Chronic illness, by text definition, is “a disease lasting three months or more, by definition of the US National Center for Health Statistics. Chronic diseases (illnesses) generally cannot be prevented by vaccines or cured by medication, nor do they just disappear-“(www.medicinenet.com). “Chronic illnesses are rarely the result of a specific pathogen. The symptoms and course are variable and ambiguous, so getting an accurate diagnosis can be a long and difficult process.” (www.encylopedia.com) Chronic means to constantly recur and/or persist for a long time. Chronic illnesses are generally progressive, meaning they get worse as a patient ages. There are two different types of Chronic Illnesses: Non-communicable and Infectious Disease. Non-communicable diseases are not spread from person to person, they are caused by other underlying factors. While infectious diseases have an underlying cause somewhere, they are diseases that are spread from person to person. Not all infectious diseases and non-communicable diseases are chronic illnesses, but the majority are. For example, Influenza (or, the flu) is an infectious disease but is not a chronic illness. Though it is almost impossible to pin down a total of how many chronic illnesses exist, they are many. Some include (in alphabetical order):

Not all chronic illnesses are created equal. Something like arthritis pales greatly to something like Cancer. Some are minor illnesses and some are painful and terminal. There are different levels of severity between the various chronic illnesses. Other factors vary as well. Some chronic illnesses are brought on by uncontrolled factors, some are brought on by the choices we make and habits we keep, while others are simply caught by another person. All chronic illnesses do share one thing in common, they are, “recurrent diseases that relapse repeatedly, with periods of remission in between.” (www.wikipedia.com) In fact, certain types of cancer are a rare example of a non-communicable chronic illness that can go away and not return. This type of exception, however, is not generally seen.

So, who is affected by chronic illness? Anyone across the world, not just the United States, can be affected by chronic illness. “Women are more likely to get a chronic illness due to their longer longevity but men are more likely to get a life-threatening chronic illness.” (www.worldhealthorganization.com) “Chronic disease risks and deaths are increasing rapidly, especially in low and middle income countries. The growing threat hinders the macroeconomic development of many countries.” (www.wikipedia.com) In the United States alone, 25% of adults in 2005 had at least 2 chronic conditions. Chronic diseases constitute a major cause of mortality, attributing to approximately 35 million deaths per year just from non-communicable chronic illness. It is thought to be up by more than 17% since 2005.” (www.worldhealthorganization.com) That means that more than 70% of all deaths in the United States alone are due to chronic illness. Some studies point out that the risk factors are the same for men and women equally when it comes to chronic illness but women tend to be the more affected gender.

When did chronic illness first begin? Much the same way that we look to date back our ancestry, scientists and medical professionals try to date back illnesses among other things. While there is no specific date of a beginning for chronic illnesses on a whole, certain (not all) chronic illnesses can be dated back individually. Take for example, Cancer – a non-communicable chronic illness. Cancer was first discovered and named further back than any other known chronic illness, in 460-370 BC. “The disease was first called cancer by Greek physician Hippocrates.” (www.news-medical.net) “The oldest description of the disease is from Egypt and dates back to about 3000 BC. It is called the Edwin Smith Papyrus and is a copy of part of an ancient Egyptian textbook on trauma surgery.” (www.news-medical.net) In the 1340’s in Europe, the Bubonic Plague killed more than 20 million people. The Bubonic Plague was an acute communicable (infectious) disease as well as a chronic illness. Chronic illness, seen sporadically throughout history, did not truly start to be understood until the late 19th century/ early 20th century. In the mid-1800s (19th Century), Rudolf Virchow’s discovered cellular pathology. Also in the mid-1800s, Robert Koch and Louis Pasteur confirmed a link between certain bacteria and certain illnesses. During that time, medical drugs were just being discovered in Europe. (www.worldhealthorganization.com). It seems there will always be new chronic illnesses to discover, unfortunately, and some, recently discovered (last 15-20 years) are still being studied. Take for example, Cancer and Fibromyalgia, two completely different chronic illnesses. While Cancer has earlier roots than most of us may have thought, other chronic illnesses like Fibromyalgia did not come to fruition until very late in the 20th century, even into the 00’s. The widespread belief that chronic diseases are only “diseases of affluence” is incorrect. Chronic disease risks become widespread much earlier in a country’s economic development than is usually realized.

The discovery of chronic illnesses over the decades has inspired new professions for individuals such as a Rheumatologist, and Pain Management doctor. Many fields of study in health and fitness have been opened as well. We understand many different types of chronic illnesses and have an idea of when they began- so, where did chronic illness come from/ where did they start and why? Meaning, what are the underlying causes and factors of chronic illness? As a note, living a life full of health and fitness is key in an effort to avoid a chronic illness. While many chronic illnesses are not contagious and can come from factors we can’t control, many are contagious; and of those that are not contagious- our life habits and factors play a role. The underlying determinants of chronic diseases – “the causes of the causes”- are a reflection of the major forces driving social, economic and cultural change. According to laboratory, clinical and population-based studies conducted in all regions of the world, the causes (risk factors) are actually known. Chronic illness did not come from a specific region but from various factors. At the root of all chronic illness, whether that illness be non-communicable or infectious disease, there are underlying factors that started it all. These underlying socioeconomic, cultural, political and environmental determinants are – (1) globalization (2) urbanization and (3) population aging and (4) general policy environments. These are factors outside of our control wherein a bacteria/germ/superbug of some kind grew and spread based on its environment. Common modifiable risk factors include (1) unhealthy diet, (2) physical inactivity, and (3) tobacco use. Non-modifiable risk factors are (1) age (2) heredity and, (3) gender (Endometriosis as example here, strictly a female illness). Intermediate risk factors include, (1) raised blood pressure (2) raised blood glucose (3) abnormal blood lipids and (4) overweight/obesity. More risk factors have been identified but account for only a small percentage. Infectious agents, some environmental factors and both psychosocial and genetic factors also play a role. (www.worldhealthorganization.com)

How does the role of health and fitness fit into the world of chronic illness? Proliferation of chronic illness challenges the medical model of illness, current organizations and is the focus of medical care. The medical model of illness, which considers chronic ‘illnesses’ to be chronic ‘diseases’, traditionally focuses on discovering a link between specific illnesses and their biological agents (germs). Due to the fact that chronic illnesses are generally incurable (there is a few exceptions), and many chronic illnesses do not have medication readily available for the patients, Doctors and Physical Therapists and other medical professionals are working to do what they can for the affected patients. The world of health and fitness comes into play here because the medical professionals are discovering what health fanatics may have already known, eating healthy and keeping a daily schedule of exercise helps the illnesses. In fact, some believe that eating a strictly vegan diet with minimal exercise 2-3x a week could help to get rid of certain chronic illnesses that were previously believed to be lifelong. This theory among others has not been proven. Still, there is evidence that eating healthy and exercising regularly certainly helps manage the symptoms. While it may seem confusing to a patient who is badly suffering from a chronic illness, wondering how they are going to ever do any sort of an exercise, they can- with help. Whether it be through the doctor’s office, a physical therapist or a yoga instructor, the more a ‘sick’ patient can exercise and eat right, the better chance they will have of reaching remission and living the most fulfilled life they can. Such exercises could include something simple like quick stretches or walking slowly on a treadmill 2-3 times a week. Eating healthy could just include no carbs and no snacking after dinner.

In conclusion, we have learned about chronic illnesses and the history surrounding the different types of chronic illnesses – including information such as what is chronic illness, who do they affect, where do they come from and why. We have also looked at chronic illnesses from a health and fitness perspective and learned that all of us need to be conscious of what we eat and exercise in order to stay and remain healthy. Do you know anyone with a chronic illness? Ask them if there’s something you can do for them today.

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